Thursday, April 17, 2008

Chest Pain, Hoof Beats and Zebras

(If you are having these symptoms, CALL AN AMBULANCE NOW.
  • Crushing pain or uncomfortable pressure in the middle of your chest that lasts more than a few minutes
  • Squeezing pain in the chest or left upper arm
  • Sweating and nausea
  • Severe shortness of breath)


Uncertainty is the only certainty there is, and knowing how to live with uncertainty is the only security.

John Allen Paulos


Chest pain can be frightening. Chest pain after having had a heart attack takes on a whole new meaning.

I had a severe heart attack two years ago. Since then, every time I experience chest pain or chest discomfort it stops me in my tracks.

If there is any question that the chest pain could be a developing heart attack, this is what I find myself doing:

-- Lying down.
-- Chewing an aspirin (It’s absorbed faster that way and thins the blood).
-- Checking to make sure that the nitroglycerin is near-by.
-- Reviewing the symptoms of a heart attack in my head.
-- Practicing breathing exercises.
-- Watching to see if the symptoms are increasing.

I probably get noticeable chest pain at least every other day. Over the last two years, I was close to taking nitroglycerin and calling an ambulance about six times. Each time the symptoms diminished within twenty to thirty minutes, and did not increase substantially.

I have learned several things about origins of the chest pain:

-- Initially, some of the feeling of discomfort in the chest was due to taking new medications, or taking medications without eating something.

-- As much as I like coffee, it is just not worth the uncertainly to drink it. The symptoms of indigestion can mimic that of a heart attack.

-- Anxiety also mimics heart problems; many of the people seen in the emergency room for a heart attack are experiencing severe anxiety. This is a hard symptom to sort out; focused breathing usually reduces the chest pain if this is the case.

I am looking forward to when technology develops a dashboard type read-out for bodily symptoms, like a light flashing on and off when the engine is overheated or the oil is low.

I have probably experienced some kine of chest pain or discomfort more than four hundred times since my heart attack. None of the experiences turned into another heart attack. There is a wonderful saying, “If you hear hoof beats, think horses, not zebras.” However, once one has experienced the zebra, however, chest pain can always feel like the end of the alphabet is near.

You never know.

Web Links

A more in-depth review of chest pain symptoms
(beginning April 23, 2008)

Why chew aspirin

Basic breathing exercises

John Allen Paulos

Memoir of a Heart Attack

None of this is meant to be a substitute for medical advice. Make sure that you have a physician who listens to you.